Portugal (en)
Despite the progress of medicine, the surgical treatment remains the only way to completely get rid of varicose veins. The therapeutic methods are effective only at the beginning of the disease, but they do have a value that supports the nature. Today, minimally invasive procedures are performed in an outpatient setting and does not require a long restoration. And even traditional phlebectomy, is done according to a methodology.
Varicose veins is accompanied by painful symptoms and psychological discomfort, to the care of the defects. And suffer in the first place the women. The drugs will not help you to resume tense inflamed veins lost functions, in particular on the 3 and 4 stages of the disease. The only option to recover in the feet of the normal blood circulation is varicose vein surgery. If you do not remove the dead of vienna, can not avoid the complications in the form of thrombosis and trophic disorders.
The necessity of an operation upon varicose veins on the feet is determined individually. The choice of the methodology depends on the scale of the defeat, the age of the patient, the presence of comorbidities. Has the value of the weight of the patient. In no symptoms of the illustrates the surgical intervention:
The doctor may take the decision to carry out an operation in the event of varicose veins is complicated by the different diseases of vessels or of other co-pathologies, for example, a thrombophlebitis.
Even a small trauma of the operation makes it absolutely safe. Before making a decision, a vascular surgeon studies the medical history of a patient to the subject of contra-indications. The surgical treatment is unacceptable of the following pathologies:
A contra-indication to surgery is the pregnancy and the breastfeeding period, a high degree of obesity, age over 75 years of age. We can't operate lying sick or disabled.
In the current clinical practice in the surgical treatment of varicose veins is done in several ways. The task of the surgeon to exclude the circulation of blood dead blood vessels, which is at their disposal with the help of a special equipment of the microsurgery. Modern surgery to the varicose veins is a minimal intervention with a good cosmetic effect.
Sclerotherapy refers to non-invasive methods of treatment of varicose veins. If it is made in the early stages of the disease, its result will be a complete healing. In the last stages of its combination with other types of intervention.
As a methodology sclerotherapy use on small branches of the surface vessels. During an operation on the large veins remove of small, remote branches of veins into the final phase. Types of sclerotherapy:
After the procedure leaves no trace on the skin, which is his absolute dignity. The disadvantages of the possibility of a relapse of the disease, as the skyline of vienna is not close completely.
Laser Photocoagulation of the vessels — a minimally invasive method of treatment of varicose veins. Its advantage lies in the possibility of the operation, even in the presence of venous ulcers. There are two ways to laser coagulation — percutaneous and other trans-dermal eliminate spider veins. This method uses only containers of more than 3 mm in diameter. A laser beam, without passing through the skin, heats up the capillaries up to 70°C. They fuse, the circulation of the blood, she stops. The restriction to the organisation of a laser coagulation is used, the diameter of the vein — it should be at most 1 see the Procedure would be as follows:
The whole operation takes no more than 45 minutes. As an echo, the sclerotherapy, it is performed under ultrasound control. The rehabilitation period (up to the complete disappearance of traces and dilated vessels) takes a month and a half. The first five days, you have to constantly wear a compression garment and follow all recommendations of your doctor.
With the help of an electrocautery device is used to obtain the same effect as when the laser exposure. For the coagulation and in the removal of the container used electrodes connected to a high frequency generator of the current. Technique exists since the middle of last century, is considered outdated and is rarely used in current clinical practice.
The removal of varicose veins using low temperatures is not practiced in our country. For cryosurgery requires expensive equipment and highly qualified specialists. It is the only way to ensure the safety of operations. The principle of operation is similar to the laser of the coagulation — receptacle excreted from the circulatory system through the clearing.
Sometimes it is impossible to be limited to remove only the trunk of the saphenous veins, in order to eliminate the reset. To do this, you want to stop the flow of blood in the veins, connecting the surface of the deep vessels. These operations when the varicose veins are needed when pollutants trophic changes. The procedure is an endoscopic procedure, which requires only a small incision in the upper part of the tibia. The crossing of the vessel is ultrasound a pair of scissors. Today, the endoscopic procedure also little bit popular and electrocautery. It is gradually replacing the modern technology for non-invasive methodology.
Stripping — soft option for the surgery of varicose veins. The removal of a patient from vienna, entirely or solely of the affected area is produced by small incisions using the special tool — special probe. The incisions are made a little below the groin and above the fossa popliteal or above the ankle and in the fossa popliteal. Vienna, engraved with the two ends and bandaged, and the affected area removed. The operation is performed under local anaesthesia and lasts approximately an hour and a half. It allows you to remove the diseased vessel, regardless of its length and diameter. Modern phlebology use a special variant of the operation — the uprooting of veins through the perforations.
The method of radiofrequency ablation doctors have borrowed the cardio-surgical practice. It is the obliteration of the vessel under the action of high frequency, the current, the creation of the temperature up to 120°C. So as not to damage the surrounding tissue around the vessel special of analgesics the drug is formed in a water bed of feathers". A single pulse gives the opportunity to deal with 7 cm of vienna. The device is equipped with an automatic control of the temperature in the container, and a regulator power supply.
The transaction provides for the dressing of the veins in the neighborhood of the leg. Is it in a thin small incision using an endoscopic instrument. Indications for rapid intervention on the latter stages of varicose veins:
The operation Mueller, or mini-phlebectomy, applies when the thrombosis and the strong varicose veins. Through small incisions are retrieved from the patients of vienna. The incisions sewn up with one, and focus plaster, so after the operation on the skin, leaving no traces. The operation Mueller is considered one of the best ways of surgical treatment of varicose veins, because it is not the recurrence of the disease.
One of the most effective and most sought after operations for removal of varicose veins on the legs — combined phlebectomy. Its stages at different stages of the disease are used the self-treatment methods:
Before the operation necessarily of a survey. The purpose of the diagnosis — to determine the general condition of the patient. To do this, make the lab tests. To determine the degree of varicose veins, and the location of the plot, to delete, using ultrasonic Doppler scanning. In some cases an affected computer or magneto-magnetic resonance.
Minimally invasive operations are carried out without special training. If you are considering a combined operation, on the eve of the patient recommend eating light in the evening (later than 6 o'clock in the evening) and do the enema. The selection of swimsuits, compression is done in advance. The operation of varicose veins of the lower limbs is performed on an empty stomach, with a preview of the ultrasound study of the vein to remove.
The operation to get rid of varicose veins on the legs should eliminate the reflux (reverse flow of venous blood). Using at each step the modern techniques, even combined phlebectomy carried out today in a hospital of one day, it is the patient is prescribed to the house the day after the operation. In this case, general anesthesia is not necessary. If you make the size of the intervention, the patient give a general anaesthetic or are spinalnuyu anesthesia (anesthetized only the lower part of the body). The time of stay in the hospital 1-2 weeks.
The first phase of the circulation of the blood appears under the skin of vienna by the ligature or crossing at the junction with the depth of vienna. Depending on the location of the affected area, an incision is made in the groin area or in the fossa popliteal.
After the passage of the saphenous vein is removed. Are usually limited to the thighs terrain (short of Stripping), because that most often suffers. The removal of the probe is considered to be the most reliable way. To do this, in the neighborhood of the ankle or the upper part of the tibia is made another incision. The probe with a cutting tool at the end is run through one of the holes and shaped in the second. The end of vienna is attached to the instrument, and is recovered to the outside. More forgiving method PIN-Stripping. The end of the sick in vienna, just fixing with a wire to the vessel wall, and the surgeon pulls it, turning it upside down.
The next step is the ligation perforating veins. If a little, and that the fascia muscle is dissected. This allows them to avoid cosmetic defects. If the defeat of the plurality, the doctor is obliged to dissect the muscles, which gives more lasting results. The application of the endoscopic procedure allows to make the operation less traumatic, but it is not performed in all clinics, it requires a complex equipment is expensive.
Finishes an operation mini-phlebectomy, allows you to clean up visible of the inequality of the vessels. Following marking on the skin, the surgeon by means of small perforations removes small veins. Ends the operation of suturing and the band lastique.
